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Current Projects

The WHO Alcohol, Substance & Smoking Involvement Screening Test (ASSIST) Phase III

The WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and associated Brief Intervention (BI) was developed in 1997 by the World Health Organization and specialist addiction clinicians and researchers in response to the overwhelming public health burden associated with problematic substance use worldwide. The WHO Centre was a key contributor to this development. The ASSIST has undergone significant testing in a range of countries including Australia, Brazil, India, Ireland, Israel, Palestine, Thailand, UK, USA and Zimbabwe to ensure that it is feasible across different cultures and reliable (Phase I) and valid and able to be linked in to a Brief Intervention (Phase II).

Phase III is a Randomised Controlled Trail of brief interventions for illicit drugs linked into ASSIST scores. Phase III is currently in progress (2003 – 2007) in four countries.

WHO Collaborative Study on Substitution Therapy of Opioid Dependence and HIV/AIDS

The WHO Collaborative Study is a multi-site international study that aims to evaluate the effectiveness of substitution treatment for opioid dependence in relation to HIV/AIDS treatment and prevention in a number of developing and transitional economies in Asia (China, Indonesia, and Thailand), Eastern and Central Europe (Lithuania, Ukraine, Poland), and the Middle East (Iran). The study involved the collection of outcome and process evaluation data at each of these sites. Outcome data were also collected from an Australian Site (Adelaide) to serve as a benchmark for comparisons. Two centres were responsible for coordinating the study – the Adelaide WHO Collaborating Centre and one in Zurich. Manuals for Process and Outcome Evaluation of Opioid Substitution Programs and a final technical report are due to be released shortly.

In addition, a standardised program evaluation manual developed through this WHO Collaborative Study on Substitution Therapy of Opioid Dependence will be disseminated through WHO Centre networks. The standardised manual together with technical support from the WHO Centre aims to encourage and support developing countries to undertake evaluation of existing or newly introduced substitution treatment for opioid dependence and HIV/AIDS.

Systematic reviews of treatment effectiveness

An Evidence-Based Practice Unit is based in the WHO Centre. The focus of the Evidence-Based Practice Unit is the critical appraisal of research into the effectiveness of treatment for alcohol and other drug dependence.

This work is undertaken through the preparation and maintenance of systematic reviews, which are published through The Cochrane Library, peer-reviewed journals, as DASSA research monographs, and as components of monographs published by the Australian National Council on Drugs and the National Drug Strategy.

A secondary focus of the Evidence-Based Practice Unit is the preparation of reviews of the health effects of alcohol and other drug use and concepts of treatment and treatment effectiveness.

The Cochrane reviews have a particularly high international profile. The Cochrane Library is disseminated via the web (www.thecochranelibrary.com) and on CD (issued quarterly).

Methadone Substitution Treatment Training in Vietnam

Since 2005 the WHO Centre has provided ongoing technical advice, training and continuing support for Family Health International Vietnam to establish methadone maintenance treatment (MMT) in Vietnam. As part of that commitment a course on drug addiction counseling was developed to train social workers and general counselors. The program resulted in the first training course for drug addiction counseling for Vietnam.

The next phase of this work will involve the recruitment and training of a workforce to provide substitution treatment.

Develop clinical resources for substitution treatment in Vietnam.

The Adelaide WHO Centre is collaborating with Family Health International Vietnam to develop and culturally adapt clinical resources for health care clinicians. These resources will provide the necessary knowledge and skills for the introduction of MMT into Vietnam. The clinical resources will include:

• Clinical guidelines for the treatment of opioid dependence with MMT that integrates HIV prevention, treatment and care;
• Associated ‘train-the-trainer’ packages for medical and nursing staff who want to work in MMT.
• Principles and procedures for staff mentoring and supervision

Toolkit for opioid dependence treatment and rehabilitation and related HIV/AIDS prevention. An integrated planning, training and implementation guide.

The toolkit is an integrated planning, training and implementation guide for safe and effective treatment that will provide Burma, Cambodia, Lao PDR and Thailand with the tools to guide and support the introduction or scale-up of evidence-based drug substitution treatment services. A focus of the tool kit is models for cooperation between opioid dependency treatment and HIV prevention, treatment and care.

Research to investigate the extent of hazardous and harmful drinking patterns among female commercial sex workers (FCSWs) in the Asia-Pacific region.

Female commercial sex workers (FCSW) represent an occupational group that are at risk of developing hazardous and harmful use of alcohol. FCSW in the Asia Pacific region who work in licensed premises such as bars and night-clubs are at risk of high risk drinking prior to and during work with their customers. For many FCSWs this may lead to regular, hazardous consumption of alcohol. Excessive consumption may moderate the likelihood that FCSWs will require condom usage and also mediates several specific high-risk sexual risk behaviours. This constitutes a potentially serious public health problem.

To date there have been no specific studies among FCSW in the Asia-Pacific region that have examined hazardous drinking and associated risk taking behaviour. The WHO Centre is conducting a pilot study in Bangkok Thailand in collaboration with the Institute of Health Research Chulalongkorn University and the Institute of Psychiatry King's College London. The pilot aims to inform the development of a larger intervention study that would seek to reduce alcohol-related hazardous and harmful HIV and other behaviours in the target population.

United Nations Office on Drugs and Crime (UNODC) Training Centre.

In December 2005, the United Nations Office on Drugs and Crime (UNODC) launched the "International Network of Drug Dependence Treatment and Rehabilitation Resource Centres," a global initiative to address the growing demand for accessible and quality drug treatment and rehabilitation services.
Participating centres are located in Australia, Brazil, Canada, China, Colombia, Egypt, Germany, India Indonesia, Iran, Kazakhstan, Kenya, Mexico, Nigeria, Russia, Spain, Sweden, United Kingdom and United States.

This project aims to increase the technical capacity for the provision of diversified and effective drug treatment and rehabilitation services in several regions. Its objective is to develop a network of centres capable of delivering and disseminating a variety of effective treatment and rehabilitation interventions through:
1) Identifying and bringing together 20 resource centres;
2) Developing training materials;
3) Building the capacity of treatment professionals at resource centres and empowering them to act as trainers and multipliers in their respective regions and;
4) Support working groups from the resource centres to synthesise good practices on priority topics.

The WHO Centre is part of the consortium lead by the Integrated Substance Abuse Program based at University California Los Angeles (UCLA) that is charged with training the twenty selected resource centres.

Asia Pacific Column Drug and Alcohol Review

The WHO Centre is responsible for the Editorial base for the Asia Pacific Column in the Drug and Alcohol Review. The peer reviewed column is an opportunity to promote significant research being undertaken in the region.

Evaluation of the Efficacy of Drug Treatment in the Prevention of HIV Infection Among Opiate Dependent Injectors

The WHO Centre provides technical advice for the HIV Prevention Trials Network (HPTN). This group is sponsored by the US Division of AIDS, US National Institute of Allergy and Infectious Diseases, US National Institute on Drug Abuse, US National Institute of Mental Health and the US National Institutes of Health to conduct a study investigating the efficacy of drug treatment program involving administration of a buprenorphine/naloxone combination (Suboxone) in prevention of HIV infection among opiate dependent injectors. The open label multi-site randomized-controlled study involves recruiting 1,500 opiate dependent injection drug users and will be conducted in southern China (Guangxi and Xinjiang) and northern Thailand (Chiang Mai).

WHO Mental Health Action Programme (mhGAP)

The mental health Global Action Programme (mhGAP) aims to enhance the capacity of developing countries to address the stigma and burden of mental and substance use disorders. The Global Research Fellowship Project was devised to enable candidates from developing countries to embark on a small research project to facilitate training in the development of research skills in mental health and substance use areas. The WHO Centre is a host organisation for selected research candidates.

Postgraduate student support

The WHO Centre provides postgraduate student support in the form of two three-year student scholarships for PhD work. In addition to PhD students, the WHO Centre believes it is also important to support other postgraduate students as they contribute directly to the Discipline of Pharmacology and to the work of the WHO Centre.